Library

Surgery (Waike) is so named because conditions such as carbuncles (Yongju), ulcers, and sores manifest externally. However, surgical treatment must be rooted in internal medicine. By understanding the internal mechanisms, one can grasp external manifestations as clearly as looking at one's own palm. The Classics state: "Changes from rich and greasy foods can give rise to large carbuncles." This arises from toxins accumulating internally due to a diet of rich and greasy foods. It also states: "When Ying Qi (Nutritive Energy) does not flow smoothly and rebels within the muscle tissue, abscesses and swellings occur." Thus, abscesses and swellings arise from Ying Qi rebelling within the muscle tissue. Internal pathology manifests externally. Treating external symptoms while neglecting internal roots is described as "not examining the root but attempting to align the branches," which inevitably leads to error. The practitioner may remain unaware, and the patient may not realize they have been harmed. Alas! Even if the practitioner is unaware, Heaven knows; even if the patient does not realize it, the Spirits discern. Future retribution from Heaven or condemnation by the Spirits will fall either upon the individual or their descendants. Fearing this, I compiled this book, titled *Examples of Surgical Principles* (Waike Lili). The discussions on treatment recorded therein are all grounded in medical principles. If students can emulate these examples and extend them, seeking the subtle meanings not explicitly stated by the ancients, they may avoid minor errors for themselves and major errors for others, thereby benefiting future generations. Upon completing the compilation, I obtained Mr. Xue Xinpu's work on the elaboration of heart methods. Observing his discussions on treatment, I found them also firmly based on principles, and I was secretly pleased that my views aligned with his. Consequently, I incorporated his theories into the text, hoping to create a comprehensive work free of regret for learners. This is the preface.

Recorded by Wang Ji of Qimen on the Winter Solstice day of the eleventh month in the winter of the Xinmao year of the Jiajing era.

All affairs under heaven involve principles. However, there are correct and deviant aspects, and constant and variable elements; they cannot be viewed uniformly. Consider warfare: declaring war to punish crimes is the "correct" approach; secretly marching troops to raid enemy territory is the "deviant" approach. Under constant circumstances, one arranges formations according to maps and defends strategic high ground; under variable circumstances, one conceals movements and employs unpredictable strategies akin to ghosts and spirits. Medical practice is similar. Therefore, observing complexion, listening to sounds, examining symptoms, and palpating pulses constitute the "correct" aspect of medical principles. Rigidly applying fixed prescriptions and mechanically calculating dosages constitutes the "deviant" aspect. Differentiating symptoms via pulse diagnosis, adjusting formulas according to seasons, distinguishing meridians, and identifying exterior-interior relationships represent the "constant" approach. Relying on pulse rather than symptoms, or symptoms rather than pulse, prescribing based on temperament, or medicating based on physical constitution, represents the "variable" approach. While the "correct" can be adhered to, the "deviant" adapted, and the "constant" learned, the "variable" is difficult to exhaust. How can medicine be discussed lightly? Why do contemporary surgeons only observe external symptoms and the swelling or ulceration of sores, without investigating the differences in pulse deficiency-excess and meridian exterior-interior relations? It is difficult to achieve accurate medication without error. Deeply lamenting this, the Master compiled this book, naming it *Examples of Surgical Principles*. The rationale is that the applications of correct, deviant, constant, and variable approaches each have their examples, yet all converge on a single principle. If students can seek the unstated intentions and expand the unspoken subtleties through this framework, their clinical application of medicine will be guided by principles, preventing rash actions that harm lives. This is the reason for the Master's writing.

Written by Chen Jue of Shishu, Qimen, Xin'an, on the first day of the first month in the spring of the Dingyou year of the Jiajing era.